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Advanced Scoliosis
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Scoliosis is a common condition characterized by a sideways curvature of the spine, often emerging during puberty. While its origins can vary, most cases are mild. However, without proper attention, severe deformities may lead to significant functional disabilities, impacting lung function and overall well-being.
Scoliosis is a pathological condition that affects the spine and causes it to deviate (tilt) from one side to another, and also rotate the vertebrae in this direction, so that the spine is not vertical. In this case (S), several curves are also formed under the influence of the body's weight, which sometimes form the shape of a letter
Most cases of scoliosis are mild, but some curves get worse as the child grows. Severe bends can lead to disability. Severe spinal curvature can reduce the amount of space within the chest; This makes it difficult for the lungs to work as they should
..More questions
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Spinal curvature and its causes
Spinal curvature has many causes
The curvature may be secondary to a congenital deformity of the vertebrae, and the curvature appears from birth and then develops with growth. The curvature may be secondary to a disease such as: neurofibromatosis, and the curvature may be associated with a syndrome that includes several diseases, but the most famous type of curvature is spontaneous curvature, and it may affect the child since Birth or at the age of “one year”, “2 or 3”, but the most famous types of spontaneous curvature affect children at the age of “10” years, and surgical intervention is determined based on the patient’s examination and the degree and type of curvature.
Spinal curvature in children and young people
Curvature of the spine affects 4 out of every 100 children in the growing stage, and the curvature may be thoracic, or it may be lumbar, or
S may be in the shape of a letter
There may be 2 curvatures in the chest and a third curvature in the lumbar, and the curvature varies in treatment according to the degree of curvature and according to the age of the child or young person. Curvature from 10 degrees up to 25 degrees only needs to be followed up with x-rays with exercise, but if the curvature reaches 25 degrees, then 40 degrees, so he needs to wear a special belt that is tailored to the child or young person’s body
Curvature after 45 degrees requires surgical intervention, as it continues to increase even after the end of its growth. It is not recommended to delay curvature to high degrees, as as the curvature progresses above 100 degrees, the risk of surgical intervention increases.
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Does the severity of the curvature affect the risk of surgery?
Certainly, the lower the degree of curvature, the lower the risk of surgical intervention. Likewise, age is a very important factor
The younger the patient, the lower the risk
The amount of repair will be better.
The amount of impact on the lungs is less -
Bone softness is at its best.
Therefore, we advise you not to neglect your health because your health is important to us
Can I live a normal life after surgery?
The idea of fearing cartilage surgery and living life in a chair has become an old idea and has completely disappeared because science has advanced so much that cartilage surgery is the simplest type of surgery, and spine surgeries include a very large group of “manifold” surgeries, and the results of the surgery are more than 90%. In some cases, the result reaches 99% positive, meaning that after the operation is performed, the patient lives with a normal quality of life
The summary from this statement is that spine surgeries are very successful, but it is required that the doctor who will perform the surgery be highly specialized in spine surgery.
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The difference between secondary warping and automatic warping
Congenital malformation is considered one of the causes of secondary curvature, and although secondary curvature represents 10% of curvature cases, it is more dangerous than spontaneous curvature, which represents 90% of curvature cases in children and young people.
The importance of secondary curvature lies in that it is sometimes the result of nerve disease or muscle disease, sometimes it is the result of birth defects, sometimes it is part of a syndrome, and sometimes there are problems within the spinal cord or nerve canal.
It is determined whether the patient suffers from secondary or spontaneous curvature through examination of the patient and x-rays.
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What is the appropriate age for scoliosis surgery?
There is no specific age for spinal surgery, but the surgical intervention is determined based on the examination, based on the type of x-ray, and based on the type of disease, the most appropriate time for surgical intervention is determined.
But the younger the intervention, the better the results and the rate of repair
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The success rate of surgical intervention to correct scoliosis
What is the success rate of scoliosis surgery?
With scientific progress and the advancement of tools used in spinal surgery, the success rate of scoliosis surgery has reached 99%.
When is the risk high?
The possibility of great danger occurs with major distortions, secondary distortions, and posterior distortions, and it reaches very large degrees, and thus carries great risks, and this is the result of negligence.
As for natural warping, the risk is almost non-existent
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Postponing surgery to correct scoliosis until the end of growth
The truth is that there is wrong information and unfortunately it is very widespread
It is better to wait for the young man or child until he completes his growth or reaches 18 years of age, and this leads to disasters, because by then the curvature has increased to a very large percentage, and sometimes it has a severe impact on breathing functions, and things become extremely dangerous, and unfortunately, sometimes the danger reaches To a severe stage that has no solutions, and this is due to several reasons. When the curvature reaches 140 degrees and breathing functions are less than 40%, it is difficult to deal with such cases, and there is no knowledge in science of what is called postponing spinal surgery until the age of growth, so surgery can be performed in Any age depending on the patient's condition
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There are several symptoms that may accompany scoliosis, some of which we will mention below
Uneven shoulder height, where the right shoulder is usually higher -
Asymmetry in the middle, where one side protrudes and the other has a gap inward -
Protrusion of the border of the shoulders from the back -
The rib cage protrudes from behind on one side -
Protrusion of the middle on one side -
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Secondary curvature of neurofibromatosis
Neurofibromatosis affects a portion of young people and has a hereditary factor. There are two types of this disease
A type of them is common in spinal deformities, and these deformities are very violent because the nature of this disease leads to these deformities.
Sometimes the deformity is slight, but most of the time the deformity is very violent, as it occurs in difficult places in the spine.
For example, it may occur at the junction of the neck with the thoracic vertebrae, and the degree of convexity therein is very high and represents difficulty in the operation. There may be tumors either in the spinal cord or around the spinal cord around the nerve plexus, and tumors at different levels, and it appears in the patient suffering from fibroid disease. Nervous, many spots, as shown in the picture
Certain x-rays are required to check on the nerves and spinal cord. The danger lies in the fact that the possibility of problems related to the operations is high, as the infections after the operation are more than normal, and the percentage of fusion of the vertebrae is lower, and the percentage of vertebrae’s fusion is lower, and the rate of complications occurring at the time of surgery, especially if the deformity is Violence that is greater than normal, and for this reason we recommend going to the specialist doctor as soon as you notice these symptoms and not being careless so that the patient’s condition does not deteriorate.
The role of physical therapy and exercises in scoliosis
Physical therapy and exercises are helpful in correcting minor curvatures
But do exercises and physical therapy sessions benefit cases of severe curvature?
The answer is yes. Exercises and physical therapy sessions may benefit cases of severe curvature, but this is in the case that the curvature is accompanied by pain or muscle problems. Exercises work to improve the muscles, but it is impossible for exercises and physical therapy sessions to help in repairing severe curvature during the surgical stage, when the curvature exceeds 50. A degree where there is no way to repair it except through surgery, and the success rate of surgical intervention is higher than 99% when the curvature is from 50 degrees to 60 degrees. As the degree of curvature increases, the risk of surgical intervention increases.
Does lumbar disc cause scoliosis?
This question has similarities between cases of lumbar disc and cases of curvature of the spine, and the answer to this question is yes, as shown in this picture No. (1)
We see that there is curvature in the spine, and the examination revealed to us that it is not spontaneous curvature, but rather that it is secondary curvature as a result of cartilage between two vertebrae in the lumbar vertebrae. In this case, treating the cartilage treats curvature of the spine because the cartilage presses on the nerve, which leads to a deviation of the spine, and after performing the operation and removing the cartilage. By stabilizing the two vertebrae, we see that the curvature has been repaired without the need to not stabilize a large part of the vertebrae, as shown in Picture No. (2).
For this reason, the patient must be examined and x-rays taken
Curvature of the spine and its relationship to heredity
The genetic factor plays an important role in spontaneous scoliosis
The incidence of scoliosis ranges between 2% to 4%, but if the patient already suffers from scoliosis, his children are more susceptible to scoliosis, and for this reason they must be monitored continuously, especially during the stages of rapid growth, and the most dangerous stage in the stages of rapid growth is for spontaneous scoliosis. At the age of 10 years, immediately after noticing the presence of a crookedness in the child, one must go to the specialist doctor so that his condition does not deteriorate and become serious.
The belt in scoliosis
The belt is worn when the degree of curvature is from 25 degrees to 45 degrees, and the child must be in the period of rapid growth. The period of rapid growth is known through visible signs in the pelvic bones to determine the remaining growth. In girls, it is before the menstrual period or the menstrual period has not yet passed. Two years, and to wear the belt, there must be two years of growth remaining, and this belt must have specific shapes. To benefit from the effectiveness of the belt, it must be worn from at least 18 hours to 23 hours. In the case of practicing a specific sport, it is allowed to be removed during the period of sport. The effectiveness of the belt is that it prevents the development of distortion and reaching a condition. Surgery: If the appropriate belt is worn at the correct time and in the correct shape, the effectiveness rate reaches 80% in stopping the distortion and preventing the occurrence of surgery, and after the end of the period of rapid growth and certain signs in the x-ray, it will be ineffective. On the contrary, it affects muscle weakness and is harmful, not beneficial.
Curvature of the spine and its relationship to the beginning of the menstrual cycle
Spinal curvature is linked to growth. The longer the period of growth, the greater the possibility of the curvature developing, especially at the stage of rapid growth. The stage of rapid growth occurs when the menstrual cycle begins, and after this stage growth slows down, and the curvature continues to develop and increase until two years of the menstrual cycle have passed, and after For two years, the curvature slows down, and the problem is not only with an increase in the degree of curvature. When it reaches 70 degrees, its degree increases and it loses flexibility. The goal of this topic is that a girl who has not had her menstrual period must be monitored because the possibility of her degree of curvature increasing is greater, and we prohibit the parents from doing so when there is a problem. The cycle is a pivotal sign that tells us whether it will increase or slow down in its increase
The difference between scoliosis and kyphosis (kyphosis)
There is a big difference between curvature and kyphosis. Curvature is a pathological condition that affects the spine and causes it to become C-shaped or S-shaped. When we look at the patient from the front or back, we find that the spine becomes letter-shaped.
As for kyphosis, it is a severe and abnormal curvature and convexity in the spine that appears when looking at the patient from the right or left side. Sometimes the kyphosis is accompanied by curvature of the spine, and this changes the strategy that the doctor follows during surgery, as he makes the operation More dangerous
Do wrong habits cause curvature of the spine?
Some may believe that wrong sitting positions or wrong sleeping methods cause spinal deformities
The truth is that these wrong habits do not cause deformities in the spine, or even if there is curvature of the spine, these habits have nothing to do with increasing the degree of curvature.
Because curvature of the spine and curvature of the spine are diseases like diabetes and high blood pressure
But these wrong habits can affect the spine in other ways, as they affect the muscles and can cause back pain.
The relationship between scoliosis and leg pain
Some people believe that it is normal to feel pain in the thigh or foot due to curvature, but this is not true. If there is pain in the thigh or foot, this means that there is something pressing on the nerves, or the curvature could be secondary to something pressing on the nerves, or the pain may be due to several other reasons. It is not distortion per se
Sometimes the lumbar cartilage affects the nerve so severely that it creates a distortion in the spine. Therefore, the patient must be examined and x-rays should be shown to the specialist doctor.
Common mistakes caused by scoliosis
The first common mistake is that scoliosis is a rare thing, and this is not true because scoliosis is very common and the rate of spontaneous curvature is 4% of children and young people.
The second common mistake is that curvature of the spine is congenital and cannot be corrected. This is a common and widespread mistake. Curvature has many different causes. One of these causes is congenital curvature, and the most common type is spontaneous curvature. This type has an unknown cause and may be due to a hereditary factor, so the child will be normal for a while. He reaches 10 years of age and the curvature begins to appear on him. This curvature represents 90% of all children with curvature and other causes. Sometimes it is a pathological syndrome associated with curvature of the spine and we call it secondary curvature.
Therefore, it is not a requirement for a child to be born with a curvature, as the curvature may occur at a certain stage in development
The third common mistake is that a patient with scoliosis must wear a belt, and this is not true. Wearing a belt depends on specific scientific standards. The degree of curvature, the age of the child, remaining growth, and several other reasons must be known.
The fourth common mistake is that the curvature of the spine will stop increasing after it finishes growing. This is a grave and very common mistake because science tells us that when the curvature exceeds 50 degrees, it will continue to increase from one to two degrees per year for life, increasing one degree.
Curvature, which increases the roughness of the spine
The warp loses its softness and deformation occurs in the ribs, making the condition more difficult, and the increase in the degree of warp depends on growth.
The fifth common mistake is postponing scoliosis surgery until growth is complete (age 18). This is a grave mistake and has destroyed the lives of many young people. There is no knowledge of what is called postponing scoliosis surgery. Spinal surgery is available for all ages, but it depends on the extent of the deformity and the age of the child.
The sixth common mistake is scoliosis, which only affects children and does not affect the elderly, and this is not true
Curvature comes to the elderly when there is a curvature that arose in childhood and was neglected or distorted as a result of roughness, and they have different processes.
The seventh common mistake is that scoliosis has no cure. This common mistake is devastating on the organic and psychological levels
This is a result of lack of sufficient awareness, as curvature has many treatment methods, such as belt and surgery
The eighth common mistake is that as soon as the patient undergoes surgery on the spine, he becomes paralyzed. The truth is that this is a grave mistake, as science has developed greatly and surgeries have become common and their success rate is as high as
To 99%, but it should not be neglected until it reaches a stage of great danger
The effect of scoliosis repair surgery on flexibility of movement, exercise, and ability to work
Spinal curvature may affect both boys and girls, but girls are more susceptible to scoliosis, so an operation is performed for every 8 girls for every one boy. This is a good example that girls are the group most susceptible to scoliosis, and young men’s ability to work is very normal after surgery, and they can practice sports and live their lives in a way. Natural
After correcting scoliosis, when do we start eating and drinking after the operation, what to wear, and how to move
After an hour has passed after the end of the operation, we recommend drinking liquids, especially clear ones, and then gradually start eating. It is very preferable to chew gum, as it is very useful in preparing the stomach and helps in returning the normal movement of the intestines. This helps in accepting food and reduces the possibility of vomiting.
It is not allowed to wear pants on the first day of the operation due to the catheter, and therefore the patient wears a gown until the second day of the operation, when the catheter is removed. Therefore, at that time, it is allowed to wear pants and any clothing that the patient desires, and the patient must be cared for on the second day of the operation to help him move. So he doesn't get nauseous
The surgery is performed in a cosmetic manner because the patient’s appearance is important to us, but the muscles are open deeply, reaching the spine. Therefore, movement must be carried out with the help of the family, especially during sleep and while sitting and standing. We advise after the operation to walk a lot, as this helps with bowel movement.
Advantages of the latest spinal curvature methods that science has discovered so far
Science has gone through many stages over the past years until we arrived at the current method, which is repairing the curvature through multiple screws and three-dimensional repair of the vertebrae. Science has proven that this method is the newest method, the most stable and balanced, and the most effective in improving the quality of life for young people.
This method enables us to stabilize the vertebrae in a better way. Screws are placed in every vertebra in which there is a curvature in the spine, so the rate of curvature occurring again is almost non-existent.
Fixation with multiple screws allows us to control the movement and rotation of the vertebra, and this is considered a three-dimensional repair of the vertebra
This improves the rate of repair and the quality of life of young people. Therefore, the modern method of repairing crookedness enables us to perform a greater amount of repair than the repair that was done in the past.
It makes the amount of fixation much stronger and makes the quality of life better, and thus the rate of failure of the fixation system or re-warping again.
It is almost non-existent, and this reflects very positively on the young man or girl, both physically and psychologically
We believe that this method will continue for a long time because its results are very impressive, as shown in the pictures
Congenital curvature of the spine may not develop or increase in risk and does not require surgical intervention
Congenital scoliosis is considered one of the serious cases of spinal deformities. It is linked to growth and sometimes requires early surgeries at the age of one year or more depending on its development.
But do we need surgical intervention when suffering from congenital malformation?
The answer is no. Surgical intervention occurs when there is a serious deformity or when it develops. Therefore, examination, x-rays, and follow-up of the child must be done. If the congenital malformation develops, surgical intervention is required, and if it does not develop, we do not need surgical intervention. This is why we recommend constantly following up the child with the specialist doctor.
Dr. Hani Abdel Gawad explains the different treatment methods according to the degree of curvature and age
If the degree of curvature is from 0 degrees to 25 degrees, all that is needed is to follow up and wear the belt. The belt will be 80% effective if it is used correctly. If the degree of curvature is from 25 degrees to 45 degrees or more during the growth period, then this requires surgical intervention.
Pregnancy and childbirth after scoliosis correction surgery
Science tells us that there is no risk of a miscarriage, and the process of pregnancy and childbirth is normal and there is no risk, but sometimes you are more vulnerable to back pain, especially in the last months. As for childbirth, it can be “natural” or “cesarean section,” and this depends on the position of the fetus, the shape of the pelvis, and other things. Others determined by obstetricians and gynecologists
But if the fixation reaches the lumbar vertebrae, this will be a problem for the obstetrician and gynecologist if he wants to inject her with an anesthetic injection.
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